The principal goal of primary eye care is to decrease the incidence of preventable eye diseases and vision impairment. For example, primary eye exams can reveal systemic diseases such as diabetes and other blood vessels, neurologic, and endocrine disorders. Prevention of eye diseases and injuries can be accomplished through community education with a focus on nutrition and eye care safety. An effective primary and preventive eye care program can prepare your community to recognize and prevent problems associated with the eyes.
The goal of primary eye care is to decrease the incidence of preventable eye disease and vision impairment.
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There are three levels of eye care, from simple to complex. This manual focuses on eye care tasks that can be performed by community health care workers. Community health care workers include lay health workers, outreach workers, nurses, mid-level practitioners, and general practitioners. This manual will cover vision screening and basic eye care exams which can be conducted in a variety of clinical and non-clinical settings, as well as eye care education, first aid, and eye care in the field.
Three Levels of Eye Care:
This is the simplest form of eye care. At this level, the community health care worker’s tasks are to:
- Recognize eye problems,
- Screen or refer patients for treatment, and
- Teach the community the prevention of eye disorders.
All complex or severe eye care problems that cannot be resolved at the primary level should be referred to secondary care centers. This level of care is usually found in hospitals with ophthalmic specialists responsible for diagnosing and treating most eye problems.
This level of eye care is found in institutes of ophthalmology or specialized departments of hospitals in large cities. Specialists use operationally complex apparatus and technology. Tertiary-level practitioners perform every kind of eye care, from prevention to surgical intervention.
A Note About This Manual
Puntos de Vista: Primary Eye Cares for Migrant Farm Workers and their Families provides health workers with tools to implement primary eye programs. It is most effective when used in conjunction with a Primary Eye Care Training through Migrant Clinicians Network (MCN) or individuals who have been trained by MCN.
This manual begins with an overview of eye care services a clinic may choose to implement (Click Here), and a primer on basic eye anatomy and vision, including the signs and symptoms of common vision problems (Click Here).
Details training on how to actually perform vision screenings and basic eye exams, including how to recognize eye problems and make accurate referrals. Info Here – how to use the Focometer for measuring refractive and astigmatic errors accurately.
For sites that will be dispensing eyeglasses, Info Here – covers reading prescriptions and assembly of eyeglass kits. Info Here – provides basic first aid as well as prevention education relating to common diseases seen within the migrant population.
Finally, Info Here – specifically addresses taking primary eye care “to the field” by performing vision screening, eye exams, first aid, and prevention education in outreach settings such as migrant camps or homes.
The appendices include a list of common optical terms, a glossary of eye problems and conditions, and a useful guide to eye care resources available to migrant health clinicians.
The MCN Primary Eye Care Program
MCN is committed to developing and implementing effective primary eye care programs for clinic sites which serve migrant farmworkers.
MCN’s primary eye care Needs Assessment Survey of migrant health clinicians showed that while health centers might be interested in primary eye care, many were uncertain about the components of a primary eye care program and how to implement such a program at their site.
MCN initiated the training and manual to help guide clinics in the implementation of their own programs. Primary eye care can be effectively integrated into existing primary health care programs and can be tailored to local needs and resources. Primary eye care is a service that is not only highly desired by the client population but one that is both feasible and rewarding to implement.
MCN has been conducting on-site primary eye care training since 1995. In addition to this manual, an Eye Care Training Guide and other publications are available from MCN. MCN also fosters cooperative relationships with other agencies involved in primary eye care. Contact information for MCN is included in the Resources section in Appendix C of this manual.
Primary Eye Care Services: An Overview
The purpose of this chapter iso tout lines the basic elements essential the development of a program to provide primary eye care services at a farmworker population.
The profile of primary eye care programs will differ depending on local funding and services. However, there are a number of common elements. Primary eye care activities can act place in an outreach, clinic, or referral setting. Activities can include: vision and disease/injury screening, source prevention education, referrals for prescriptions or treatment, and/or the provision of low-cost glasses.
While many clinics provide some eye care screening of people (often only of children) in-house, very few have systems to provide more general screenings of the farmworker population.
Health care workers can screen for vision and other eye problems in a variety of settings including health fairs, migrant farmworker camps, schools, churches, one-on-one visits, and other arranged group settings. Several tools exist for effective vision screening including the Snellen chart and the computer. Other eye problems can be treated easily in the field, or when a more serious problem persists, can be referred to an ophthalmic professional.
Prevention of Education
Education about the prevention of eye problems goes hand-in-hand with screening activities. The most effective education occurs one-on-one as a person goes through the screening process. However, printed or visual preventive messages left in the community or mailable at the clinic can also be very effective, provided they are at an appropriate reading level. Primary eye care education messages should stress injury prevention, UV protection, hygiene, and nutrition.
Referrals for Prescriptions or Treatment
Screening efforts are most effective when ophthalmic professionals are available for referrals. A few health centers may have an ophthalmic professional on staff, but most will have to rely on referrals to outside sources. Communities that are reasonably close at a school of optometry can sometimes arrange for services through these institutions. Other communities work with the local ophthalmic community to provide low cost or free services at the farmworker population. [See Appendix C Eye– Care Resources.]
Provision of Glasses
Once a prescription has been provided by an ophthalmic professional, the trained Migrant Health Clinician or outreach staff can dispense glasses of an individual.
Eye Deal Eyewear is a company whose mission is to provide corrective eyewear of high optical quality at a low price. The company sells an eyeglass collection called Instant Eyeglasses which are designed to fit an individual’s prescription and can be dispensed in only a few minutes.
The eyeglass collection has one hundred different eyeglass frames and a variety of lenses. If an individual is unable to use the lenses they can be turned off a different prescription. The collection also includes a kit to aid in putting the glasses together.
See the Resources and Appendix C of their phone number. The glasses are sold at a very low cost and the profits can be put back into the primary eye care project.
Sunglasses can also be provided either free of charge or for a small fee from the Houston Eyeglass Bank (call MCN for more information) or your local Lions Club. The sunglasses can be used as an incentive to bring people in while also serving to prevent UV damage, a serious problem among arm workers.
If your site is interested in developing primary eye care services, first fill out the Clinic Self Evaluation on the allowing of page. This will help identify the services you already provide, as well as the services you may be interested in adding.
The theorem is a tool for self-evaluation only and does not set criteria for the development of an eye care program. Often, the implementation of a program is determined by the number of offset hours you can commit at it as well as the financial support available.
Depending on the time and resources available, an eye care project may consist simply of out-reach and clinic staff training on preventive education of eye care problems.
A more complex program might incorporate optometric referrals and provision of eyeglasses. MCN is available with technical assistance, training and support services at assisting sites serving migrant farmworkers to implement some or all of the elements of an eye care project.
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